Evidence map›Paper›PMID 31074780›Full record

ArticleInternational journal of epidemiology2019

Getting more from heterogeneous HIV-1 surveillance data in a high immigration country: estimation of incidence and undiagnosed population size using multiple biomarkers.

Federica Giardina, Ethan O Romero-Severson, Maria Axelsson, Veronica Svedhem, Thomas Leitner, Tom Britton, Jan Albert

Abstract read
In one paragraph

Article in International journal of epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Sweden surpasses the UNAIDS 95-95-95 target: estimating HIV-1 incidence, 2003 to 2022.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2024
    Article
  6. Article
  7. Article
  8. Factors Associated with HIV Testing among Male Students Who Have Engaged in Sexual Behaviour in Zhejiang Province, China.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2023
    Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Modeling methods for estimating HIV incidence: a mathematical review.Theoretical biology & medical modelling · 2020
    Review
  16. Challenges in modelling the proportion of undiagnosed HIV infections in Sweden.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Federica GiardinaDepartment of Mathematics, Stockholm University, Stockholm, Sweden.
Ethan O Romero-SeversonTheoretical Biology and Biophysics Group, Los Alamos National Laboratory, Los Alamos, NM, USA.
Maria AxelssonDepartment of Public Health Analysis and Data Management, Public Health Agency of Sweden, Solna, Sweden.
Veronica SvedhemDepartment of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden.
Thomas LeitnerTheoretical Biology and Biophysics Group, Los Alamos National Laboratory, Los Alamos, NM, USA.
Tom BrittonDepartment of Mathematics, Stockholm University, Stockholm, Sweden.
Jan AlbertDepartment of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden.

Funding

Reconstructing HIV Epidemics from HIV PhylogeneticsR01AI087520 · NIAID · TRIAD NATIONAL SECURITY, LLC · PI Thomas K. Leitner · 2010 to 2026
$11.2M
NIAID NIH HHS R01 AI087520
6 · The paper itself

Abstract

backgroundMost HIV infections originate from individuals who are undiagnosed and unaware of their infection. Estimation of this quantity from surveillance data is hard because there is incomplete knowledge about (i) the time between infection and diagnosis (TI) for the general population, and (ii) the time between immigration and diagnosis for foreign-born persons.

methodsWe developed a new statistical method for estimating the incidence of HIV-1 and the number of undiagnosed people living with HIV (PLHIV), based on dynamic modelling of heterogeneous HIV-1 surveillance data. The methods consist of a Bayesian non-linear mixed effects model using multiple biomarkers to estimate TI of HIV-1-positive individuals, and a novel incidence estimator which distinguishes between endogenous and exogenous infections by modelling explicitly the probability that a foreign-born person was infected either before or after immigration. The incidence estimator allows for direct calculation of the number of undiagnosed persons. The new methodology is illustrated combining heterogeneous surveillance data from Sweden between 2003 and 2015.

resultsA leave-one-out cross-validation study showed that the multiple-biomarker model was more accurate than single biomarkers (mean absolute error 1.01 vs ≥1.95). We estimate that 816 [95% credible interval (CI) 775-865] PLHIV were undiagnosed in 2015, representing a proportion of 10.8% (95% CI 10.3-11.4%) of all PLHIV.

conclusionsThe proposed methodology will enhance the utility of standard surveillance data streams and will be useful to monitor progress towards and compliance with the 90-90-90 UNAIDS target.

Indexed as

Bayes TheoremBiomarkersEmigration and ImmigrationHIV-1HIV InfectionsHumansIncidencePopulation DensityProbabilityPublic Health SurveillanceSwedenBiomarkersBED assayHIV-1incidence estimationpol sequencesundiagnosed HIV-1 infections

Identifiers

PMID31074780
PMCPMC6929534

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.